MEDICARE: MS. SERENA TORREY MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	1041C0700X	Clinical Social Worker	220912	MA

General Provider Information

NPI Number	:	1992125579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SERENA TORREY MSW

Provider Business Mailing Address
First Line	:	158 PLEASANT ST
Second Line	:
City	:	PLAINFIELD
State	:	MA
Zip	:	01070-9781
Country	:	US
Telephone Number	:	413-695-8055
Fax Number	:

Provider Business Practice Location Address
First Line	:	158 PLEASANT ST
Second Line	:
City	:	PLAINFIELD
State	:	MA
Zip	:	01070-9781
Country	:	US
Telephone Number	:	413-695-8055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	04/26/2016

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